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General NPI Number Information
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NPI Number | 1104970268
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Entity Type | Organization
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Legal Business Name | STEVENS COUNTY
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 09/21/2015
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Provider Practice Location Address
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Address Line | 425 N HIGHWAY
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City | COLVILLE
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State | WA
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Zip | 99114-2139
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Country | US
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Telephone | 509-684-8261
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Fax |
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Provider Business Mailing Address
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Address Line | 425 N HIGHWAY
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City | COLVILLE
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State | WA
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Zip | 99114-2139
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Country | US
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Telephone | 509-684-8261
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Fax |
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | WILLIAM D BUSCHER
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Credential |
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Telephone | 509-684-8261
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 33X01
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License Number State | WA
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